Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Radiant Skin Dermatology and Laser, PLLC

Organization Dermatology Physician · NPI 1861738460

Radiant Skin Dermatology and Laser, PLLC provides Dermatology Physician services in New York, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

207 W 115th St Lowr Level
New York, NY 10026-2965
Phone: (212) 229-0007
Fax: (347) 274-8349
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 256265 (NY)

Record details

NPI number1861738460
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adebola Dele-Michael — Owner · (212) 229-0007
NPI enumeratedDecember 31, 2012
Last updated in NPPESMarch 4, 2024
Certification dateMarch 4, 2024
Mailing address234 Central Park W, New York, NY 10024-6003

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